Refund Request for Docket No. 26-001041.pdf
Fc Country LLC Petitioner Vs. City Of Mt Pleasant Respondent · 26-001041-TT
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__________________________________________________________________ __________________________________________________________________________ STATE OF MICHIGAN GRETCHEN WHITMER DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS MARLON I. BROWN, DPA GOVERNOR DIRECTOR LANSING MICHIGAN TAX TRIBUNAL REFUND REQUEST Payee Name: ______________________________________________________________ Payee Address: ____________________________________________________________ MTT Docket No:_________ Amount of Refund Requested:$_________________________ Reason for Refund: ☐Filing/Motion Fee Overpaid ☐Duplicate Docket ☐Other _____________________________________________________________ Payment Information: Docket Lookup Line # of Payment: ______________________________________________ Date of Payment:____________________________________________________________ Check #:___________________________________________________________________ Validation/Confirmation #:_____________________________________________________ Requestor’s Signature:_______________________________________________________ For Tribunal Use Only: Computation of Refund Amount: Amount paid: $ ____________ Granted: ☐ Amount Due: $ ____________ Denied: ☐ Amount Refunded: $ ____________ Prepared by: _____ Date: ________________ Authorized by: _____ Date: ________________ Audited/Entered by: _____ Date: ________________ Refund Denied by: ______________________ Date: ________________ MICHIGAN TAX TRIBUNAL · 611 W. OTTAWA ST., LANSING, MI 48933 · 517-335-9760 PO BOX 30232, LANSING, MI 48909 · Other Carriers: 2407 N. GRAND RIVER AVE., LANSING, MI 48906 Duplicate of Docket No. 26-001785 DuCharme, McMillen & Associates, Inc. 9229 Delegates Row, Ste 375, Indianapolis, IN 46240 26-001041 600.00 14 5-16-2026 N/A 26051685637027